Expandable venous stents for treatment of the Budd-Chiari syndrome

Richard R. Lopez, Kent G. Benner, Lee Hall, Josef Rösch, C. Wright Pinson

Research output: Contribution to journalArticlepeer-review

69 Scopus citations

Abstract

The goals of treatment of the Budd-Chiari syndrome are relief of portal hypertension, relief of inferior vena cava syndrome, if present, and preservation of hepatic function. This study presents a patient with clinical resolution of the Budd-Chiari syndrome after placement of expandable metallic stents in the inferior vena cava and hepatic veins. A 26-year-old man with severe ascites and lower extremity edema but with relatively preserved hepatic function had a small gradient across a suprahepatic caval web, large gradients across an intrahepatic caval stenosis and the left hepatic vein, and an occluded right hepatic vein. Under angiographic control, web and caval stenosis were balloon-dilated, and modified Gianturco expandable metallic stents were placed in the intrahepatic vena cava. The left hepatic vein was dilated twice and a stent was placed. All gradients were completely eliminated. There were no complications and after 1 year, the stents have fully expanded without migration, edema and ascites have resolved, hepatic function has normalized, and the patient has returned to work. This new technique provides a simple, safe, effective, relatively inexpensive, and potentially long-lasting treatment for selected patients with the Budd-Chiari syndrome.

Original languageEnglish (US)
Pages (from-to)1435-1441
Number of pages7
JournalGastroenterology
Volume100
Issue number5 PART 1
DOIs
StatePublished - May 1991

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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